Contralateral Transmaxillary Corridor as an Extension to the Endoscopic Endonasal Approach to the Petrous Apex

Abstract

Introduction: The endoscopic endonasal approach (EEA) has been shown to be a safe and effective means of accessing petrous apex lesions. Lateral lesions can be accessed with extended approaches such as skeletonization and lateralization of the paraclival internal carotid artery (ICA), or a transpterygoid infrapetrous approach. These approaches introduce significant risk to the ICA and are limited to the area immediately posterior to the ICA. This paper studies the feasibility of adding a contralateral transmaxillary corridor (CTM) to provide a more lateral trajectory for access to lateral lesions of the petrous apex with a decreased need for manipulation of the ICA.